Elbow

A most useful hinge, the elbow is a very complex joint where three long bones come together. Injury, overuse, and diseases such as arthritis can cause pain in the inner or outer elbow.

Treatment options vary by patient, severity of injury and diagnosis. Conservative options such as rest, pain medication, and physical therapy should always be investigated. Other common elbow treatments can include surgery.

Tendonitis/Lateral Epicondylitis

Tendonitis/Lateral Epicondylitis is a degeneration of the tendons that attach to the bony bump on the outer side of the elbow (lateral epicondylitis). It’s often called tennis elbow though you don’t have to play tennis to suffer from it. This condition is caused by repetitive trauma (such as playing tennis or golf) or aging.

Symptoms:
Common symptoms include tenderness and pain (especially when bending the wrist) when the tendons are inflamed. Repeated twisting motions or activities that strain the tendon typically cause more pain.

Medial Epicondylitis

Medial Epicondylitis is a painful tendonitis on the inner aspect of the elbow, where the muscles that bend the wrist and fingers attach. Similar to its counterpart, tennis elbow, it’s also called golfer’s elbow, though you don’t have to play golf to suffer from it. This condition can arise from overuse of the muscles and tendons of the forearm, leading to inflammation and pain around the elbow joint.

Symptoms:
Tenderness and pain (especially when bending the elbow) when the tendons are inflamed. Repeated twisting motions or activities that strain the tendon typically cause more pain.

Treatment Options:
Initially rest, ice, splinting and anti-inflammatory medications. Can be improved with physical therapy, cortisone injection or surgery may be recommended if symptoms persist.

Biceps Tendon Tear

Biceps Tendon Tear occurs when the tendon that connects your muscle to your radius (forearm) bone tears away from the bone. It often occurs when lifting heavy objects and weightlifters are more likely to suffer from this. It may be felt as a pop in the front of the elbow and can be painful, though the elbow will usually continue to work because other muscles can do part of the job of the biceps muscle. Most common in men over age 30, but can happen in women too, and symptoms usually get better over a few weeks.

Symptoms:
Weakness, pain, swelling, bruising and warmth in the elbow. Bicep muscle spasms are also common. May experience fatigue with repetitive motions if your tendon is not repaired.

Treatment Options:
If the tendon tears completely, surgery is an option if attended to soon after the injury. If your arm is working well, you may choose not to have surgery, you may have permanent weakness and arm fatigue. You should see a physician within a week or two.

Cubital Tunnel

Cubital Tunnel is a condition that involves pressure or stretching of the ulnar nerve (also known as the “funny bone” nerve) which runs in a groove on the inner side of the elbow.

Symptoms:
Numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand. The ulnar nerve (Figure 1) runs in a groove on the inner side of the elbow. Often felt when the elbow is bent for a long period of time, such as while holding a phone or while sleeping.

Treatment Options:
Avoid actions that cause symptoms, splinting, physical therapy, sometimes surgery is required to release the nerve. A special nerve test can be done to help in making the diagnosis.

Tendon Repair

Surgery to repair a torn tendon should be performed during the first 2 to 3 weeks after injury; later than that it may not be possible to restore arm function. There are many different ways surgeons can reattach tendons to bone or to nearby muscle. A common surgical option is to attach the tendon with stitches through holes drilled in the radius bone. Another method is to attach the tendon to the bone using small metal implants (called suture anchors). There are pros and cons to each approach, be sure to carefully discuss the options with your doctor surgeon. Often, people are able to resume even heavy activities after surgery and rehabilitation.

Post-operative Treatment:
Splinting and/or physical therapy.

Recovery:
Varies by patient and severity.

Source: Source: AAOS

Ulnar nerve release (for cubital tunnel syndrome)

When the ulnar nerve in the arm becomes very compressed and non-surgical methods have not improved your condition, surgery to relieve pressure on the ulnar nerve may be an option. In this surgery, the ligament “roof” of the cubital tunnel is cut and divided. to increase the size of the tunnel and decrease pressure on the nerve. As the ligament begins to heal, new tissue grows across the division. The new growth heals the ligament, and allows more space for the ulnar nerve to slide through. These are often done on an outpatient basis

Post-operative Treatment:
You may need to wear a splint for a few weeks after the operation and your surgeon may recommend physical therapy \ to help you regain strength and motion in your arm.

Recovery:
Varies depending on patient and severity.

Source: Source: AAOS

Elbow Arthroscopy

This procedure enables orthopedic surgeons to inspect, diagnose, and repair problems inside the elbow. Your doctor may recommend elbow arthroscopy if you have a painful condition that does not respond to nonsurgical treatment. Common arthroscopic elbow procedures include: treatment of tennis elbow, removal of loose cartilage and bone fragments (known as loose bodies), release of scar tissue, treatment of arthritis.

Recovery:
Arthroscopic surgery allows for a rapid return to improved activity and offers a faster recovery than traditional open joint surgery.

Source: Source: AAOS

Operative Fracture Fixation

If you have an elbow fracture, your surgeon may use one of several operative fixation techniques to realign the bone fragments. These fragments must be held in place while the bone heals. These techniques include devices that hold the bone fragments in place either inside the body (such as wire, pins, plates and screws) or outside the body (use of pins in bone that are held in place through their attachment to an external fixation device.

Post-operative Treatment:
Cast or splint for two to six weeks after surgery, then hand therapy may be recommended to restore movement.

Recovery:
Three months or more to regain full use of the hand, depending on the severity of the injury.

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